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    Clinical and laboratory features of brucellosis in two university hospitals in Southeast Turkey
    (Royal Soc Medicine Press Ltd, 2006) Kokoglu, OF; Hosoglu, S; Geyik, MF; Ayaz, C; Akalin, S; Buyukbese, MA; Cetinkaya, A
    This prospective study was carried out in two university hospitals between January 2000 and December 2002. The diagnosis of brucellosis was made with compatible clinical findings, positive Brucella agglutination >= 1/160 titres, and/or the isolation of Brucella species. The patients were followed up without intervention. One hundred and thirty-eight patients with active brucellosis were evaluated. Of the participants, 79 (57.2%) cases were acute, 23 (16.7%) sub-acute and 36 (26.1%) chronic. Brucella melitensis was isolated in the specimens of 24 (26.9%) out of 89 patients. The most frequent symptoms were fever (78.3%), arthralgia (77.5%) and sweating (72.5%). The most common physical findings were fever (40.6%), splenomegaly (36.2%), and hepatomegaly (26.8%). The osteoarticular involvement was found in 64 patients (46.4%). Ten (7.5%) patients had orchiepididymitis. Meningitis, pulmonary involvement, endocarditis, and hepatitis were found in five (3.6%), three (2.1%), two (1.5%) and one (0.7%) patient, respectively. Relative lymphomonocytosis was found in 80 cases (58.8%), anaemia in 46 (33.3%) and leucopoenia in 30 cases (21.7%). Clinical relapse was observed in 14 patients (10.1%).
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    Prospective surveillance study for risk factors of central venous catheter-related bloodstream infections
    (Mosby, Inc, 2004) Hosoglu, S; Akalin, S; Kidir, V; Suner, A; Kayabas, H; Geyik, MF
    Objective: Risk factors of catheter-related bloodstream infection (CR-BSI) caused by central venous catheter (CVC) use at a university hospital were evaluated. Design: A prospective, observational, hospital-wide study was conducted. Setting: The study was conducted at a university hospital with 1050 beds. Methods: Nontunneled catheters were used, and double or triple lumen was observed. Catheters were cultured by semi-quantitative method, and blood cultures were performed if necessary All epidemiologic and clinical data were recorded without intervention during the study Results:Over a 1-year period, the study assessed 389 CVCs inserted in 367 patients (mean age 50.9 +/- 18.1 years; 215 [58.6%] men, 152 [41.4%] women). Duration of catheterization was 12.0 +/- 9.9 days. CVCs were inserted into either the subclavian vein (N = 263; 67.6%) or the jugular vein (N = 128: 32.4%). In 250 episodes (64.3%), antibiotics were used concomitantly CR-BSI was found in 43 of all CVCs (11.1%). The rate of CR-BSI per 1000 catheter-days was 9.21 for the whole cohort. In multivariable analysis, only renal failure (OR 4.83; Cl 1.32-17.66; P = .017) was found to be a risk factor for CR-BSI. Conclusion: Renal failure was an independent risk factor for CR-BSI.
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    Risk factors for enteric perforation in patients with typhoid fever
    (Oxford Univ Press Inc, 2004) Hosoglu, S; Aldemir, M; Akalin, S; Geyik, MF; Tacyildiz, IH; Loeb, M
    A case-control study was performed using the records of patients hospitalized for typhoid fever at Dicle University Hospital, Diyarbakir, Turkey, between 1994 and 1998. Case patients with enteric perforation were compared with control patients with typhoid fever but no enteric perforation. Risk factors for perforation were determined using logistic regression modeling. Forty case patients who had surgery because of typhoid enteric perforation were compared with 80 control patients. In univariate analyses, male sex (p = 0.01), age (p = 0.01), leukopenia (p = 0.01), inadequate antimicrobial therapy prior to admission (p = 0.01), and short duration of symptoms (p = 0.01) were significantly associated with perforation. In multivariate analysis, male sex (odds ratio (OR) = 4.39, 95% confidence interval (CI): 1.37, 14.09; p = 0.01), leukopenia (OR = 3.88, 95% CI: 1.46, 10.33; p = 0.04), inadequate treatment prior to admission (OR = 4.58, 95% CI: 1.14, 18.35; p = 0.03), and short duration of symptoms (OR = 1.22, 95% CI: 1.10, 1.35; p = 0.001) were significant predictors of perforation. A short duration of symptoms, inadequate antimicrobial therapy, male sex, and leukopenia are independent risk factors for enteric perforation in patients with typhoid fever.
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    Transmission of hepatitis C by blood splash into conjunctiva in a nurse
    (Mosby, Inc, 2003) Hosoglu, S; Celen, MK; Akalin, S; Geyik, MF; Soyoral, Y; Kara, IH
    The risk of transmission of hepatitis C virus (HCV) infection is an important problem for the health care worker. HCV transmission by blood splashing into eyes is very rare. In a hemodialyses department, a 23-year-old female nurse splashed blood from a patient who was anti-HCV positive into her eyes, She washed her eyes with water immediately and reported to the infection control department. She had never used intravenous drugs nor received transfusions. At the time of exposure, there was no abnormality in her laboratory tests. Her anti-HCV and HCV-RNA tests produced negative results. She was followed up for anti-HCV and alanine aminotransferase activity. After 6 months, she presented with sore throat, nausea, vomiting, fatigue, and weight loss. She had icterus and hepatomegalia. In laboratory tests, alanine aminotransferase level was 504 U/L, aspartate aminotransferase level was 388 U/L, and anti-HCV and HCV-RNA tests produced positive findings. She was treated with interferon alfa-2a for a 1-year period. After treatment, an HCV-RNA test produced negative results and transaminase levels were normal. In conclusion, splashing blood from patients who are HCV positive into the face or eyes is a risk for health care workers. They should be educated to prevent a nosocomial acquisition of bloodborne infection and they should observe protective precautions.
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    Tuberculosis among health care workers in a short working period
    (Mosby, Inc, 2005) Hosoglu, S; Tanrikulu, AC; Dagli, C; Akalin, S
    Background: Tuberculosis (TB) is an important problem among health care workers (HCWs), both in Turkey and in other countries. The purpose of this study was to determine the risk ratio and features of tuberculosis (TB) among health care workers (HCWs) at a teaching hospital in southeast Turkey. Methods: In a hospital-wide study at Dicle University Hospital, a referral center in southeast Turkey, data from HCWs with TB were collected from clinic and hospital records. The incidence and relative risk (RR) of TB among HCWs between 1986 and 2000 were analyzed and evaluated retrospectively according to TB incidence in the general population of Turkey. Results: In this 15-year period, there were 22 HCWs with pulmonary tuberculosis (9 men, 13 women; 4 doctors, 13 nurses, 5 paramedics) out of an average of 734 workers per year over the study period. The mean age of the doctors was 27.1 years; nurses, 20.6 years; and paramedics, 30.5 years. The mean working experience of HCWs was 3.5 years (2.8 years for doctors, 2.8 years for nurses, 6.4 years for paramedics). The mean incidence of TB among the general population of Turkey between 1986 and 2000 was 40.8 of 100,000 persons. The mean incidence of tuberculosis in all HCWs of the hospital was 199.9 of 100,000 persons (RR = 4.9), 127.1 of 100,000 persons in doctors (RR = 3.1), 274.4 of 100,000 persons in nurses (RR = 6.7), and 160.2 of 100,000 persons (RR = 3.9) in paramedics. Conclusion: Hospital acquired tuberculosis is prominent among young nurses who work in high-risk departments.